MedicaidReimbursementMedium impact
Fee-for-service rates for OHA/ODHS private duty nursing services effective July 1, 2023
Oregon Health Plan·OR·Provider
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Medicaid updated fee-for-service reimbursement rates for private duty nursing services effective July 1, 2023. RN hourly rates increased to $94.53 (OHA) and LPN rates to $58.90 (OHA), with corresponding rate increases for ODHS services billed in 15-minute units.
Action Required
Immediately: Billing team must update fee schedules in billing system to reflect new Oregon Medicaid rates for private duty nursing codes S9123, S9124, T1000, T1002, and T1003 for services on/after July 1, 2023. For claims already submitted with old rates, contact prior authorization processors to coordinate claim adjustments. Contact Provider Services Unit at 800-336-6016 (Option 5) for billing questions.